Low back pain (LBP) is a rapidly growing health challenge impacting millions of lives around the world. An estimated 619 million people suffer from chronic LBP (meaning they have struggled with it every or most days for the past three months). This number is expected to reach 843 million by 2050 (GBD, 2023).
As the prevalence rate climbs, LBP will continue to hold the title as one of the leading causes of disability worldwide (GBD, 2023). For many, this translates into a reduction in workplace productivity and an increase in healthcare consumption—both with the potential to damage employee well-being as well as an employer’s bottom line.
The cost of LBP in the workplace
As with any chronic musculoskeletal (MSK) condition, LBP has a profound impact on workplace productivity. However, the scale at which LBP curbs productivity is unlike many other chronic pain conditions. One nine-year retrospective claims analysis calculated a median of 27 lost work days per employee due to temporary total disability from LBP (Gaspar, 2021). The financial burden of productivity loss and absenteeism totals $225.8 billion for employers in the United States—approximately $1,685 per employee (CDC, 2015).
Still, many employees suffering from LBP continue to go to work. However, simply being present doesn’t equate to high productivity—presenteeism can be just as financially draining as absenteeism. One four-year study found that chronic back pain was the top driver of productivity loss in the US, with 16.7 minutes lost per employee per day—a grand total of $1.21 million lost due to presenteeism (Allen, 2018).
LBP doesn’t exist in a vacuum
In many cases, employees don’t suffer from just LBP. The all-encompassing nature of chronic pain can provoke a downward spiral of a person’s overall health, giving rise to comorbidities that further reduce productivity and quality of life. Two of the most notable conditions tied to LBP are fatigue and mental illness (Snekkevik, 2014). One study found that almost 70 percent of individuals with LBP experience substantial fatigue, increasing the risk of depressive symptoms and long-term disability (Snekkevik, 2014).
Likewise, obesity often exacerbates LBP due to the additional strain placed on the back, as well as other factors such as the heightened inflammatory state obesity can incite. A recent study found that almost 75 percent of individuals with LBP were overweight or obese (Siddiqui, 2022). As such, obesity can significantly amplify other LBP comorbidities. One study reported that the connection between LBP and obesity was much stronger in those suffering from an emotional disorder (Chou, 2016).
The high costs of inappropriate care
When patients are given adequate access to holistic, evidence-based care, the vast majority of LBP cases resolve with non-surgical treatment. As a first step, patients should see a specialty physician trained in non-operative MSK care who can assess the individual, render a diagnosis, and start the patient on the appropriate treatment pathway. For the vast majority of LBP cases, first-line treatment modalities will include:
- Physical therapy to restore function and address underlying muscular imbalances
- Non-opioid medications to reduce inflammation and lower pain
- Education about the nature of low back pain
- Lifestyle modifications such as weight loss or stress care
Only a small percentage of individuals with LBP require more invasive options like surgery. Yet, time after time, too many patients are inappropriately escalated to the operating room. One study evaluating second opinions for spine surgery found that over 60 percent of the recommended procedures were unnecessary (Epstein, 2013).
Moreover, surgery is not a silver bullet. In fact, up to 40 percent of back surgeries fail to improve LBP (Orhurhu, 2023). On top of long recovery timelines, these ineffective surgeries substantially increase the cost of care for employers. One analysis of 2.5 million individuals with LBP found that, among the 1.2 percent who received surgery, the costs accounted for over 29 percent of total LBP expenses—surpassing $784 million in just 12 months (Kim, 2019).
Whole-person care for LBP
The integrated nature of LBP calls for an equally integrated approach to care. One reason why a large percentage of back surgeries fail is that many clinicians are either not trained in or are not set up to offer holistic root-cause treatment. As a result, many recommend surgery without first attempting to address the underlying and interconnected causes of LBP.
Vori Health combats this problem head-on. We connect each patient with a multidisciplinary MSK care team, led by a non-operative medical doctor with LBP expertise, that works together to treat each aspect of an individual’s pain. This holistic approach, which has been certified by the Validation Institute for low back conditions, improves pain levels while also reducing surgeries, imaging, and injections. By partnering with a clinical team that cares for the whole person, employers give their employees access to the most appropriate LBP care that minimizes costs and maximizes relief.
Want to learn more about how Vori Health’s whole-person model can deliver high-value LBP care for your employees? Reach out to our team.
REFERENCES
- GBD, 2023: GBD 2021 Low Back Pain Collaborators. Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol. 2023;5(6):e316-e329.
- Gaspar, 2021: Gaspar FW, Thiese MS, Wizner K, Hegmann K. Guideline adherence and lost workdays for acute low back pain in the California workers' compensation system. PLoS One. 2021;16(6):e0253268.
- CDC, 2015: Worker Illness and Injury Costs U.S. Employers $225.8 Billion Annually. (2015, January 28). CDC Foundation
- Allen, 2018: Allen D, Hines EW, Pazdernik V, Konecny LT, Breitenbach E. Four-year review of presenteeism data among employees of a large United States health care system: a retrospective prevalence study. Hum Resour Health. 2018;16(1):59.
- Snekkevik, 2014: Snekkevik H, Eriksen HR, Tangen T, Chalder T, Reme SE. Fatigue and depression in sick-listed chronic low back pain patients. Pain Med. 2014;15(7):1163-1170.
- Siddiqui, 2022: Siddiqui AS, Javed S, Abbasi S, Baig T, Afshan G. Association Between Low Back Pain and Body Mass Index in Pakistani Population: Analysis of the Software Bank Data. Cureus. 2022;14(3):e23645.
- Chou, 2016: Chou L, Brady SRE, Urquhart DM, et al. The Association Between Obesity and Low Back Pain and Disability Is Affected by Mood Disorders: A Population-Based, Cross-Sectional Study of Men. Medicine (Baltimore). 2016;95(15):e3367.
- Epstein, 2013: Epstein NE. Are recommended spine operations either unnecessary or too complex? Evidence from second opinions. Surg Neurol Int. 2013;4(Suppl 5):S353-S358.
- Orhurhu, 2023: Orhurhu VJ, Chu R, Gill J. Failed Back Surgery Syndrome. StatPearls Publishing; 2023. Accessed July 3, 2023.
- Kim, 2019: Kim LH, Vail D, Azad TD, et al. Expenditures and Health Care Utilization Among Adults With Newly Diagnosed Low Back and Lower Extremity Pain. JAMA Netw Open. 2019;2(5):e193676.
